title: Primary study on providing a basic system for uterine cervical screening in a developing country: analysis of acceptability of self-sampling in Lao PDR.
abstract: BACKGROUND
  Most developing countries have been unable to implement well-organized health care systems, especially comprehensive Pap smear screening-based programs. One of the reasons for this is regional differences in medical services, and a low-cost portable cervical screening system is necessary. To improve regional discrepancies in cervical screening systems, we investigated the usefulness and acceptability of cervical self- sampling by liquid-based cytology (LBC) for 290 volunteers in the Lao PDR.
  
  
  METHODS
  Following health education with comprehensive documents, cervical self-sampling kits by LBC were distributed in three provincial, district, and village areas to a total of 290 volunteers, who were asked to take cytology samples by themselves. Subsequently, the acceptability of self-sampling was evaluated using a questionnaire.
  
  
  RESULTS
  The documents were well understood in all three regions. Regarding the acceptability of self-sampling, the selections for subsequent screening were 62% self-sampling, 36% gynecologist-sampling, 1% either method, and 1% other methods. The acceptability rates were higher in the district and the village than in the province. For the relationship between acceptability and pregnancy, the self-sampling selection rate was higher in the pregnancy-experienced group (75%) than in the pregnancy-inexperienced group (60%). For the relationship between selection of self-sampling and experience of screening, the self-sampling selection rate was higher in the screening-inexperienced group (62%) than in the screening-experienced group (52%).
  
  
  CONCLUSIONS
  Our data show that this new way forward, involving a combination of self-sampling and LBC, is highly acceptable regardless of age, educational background, and residence in rural areas in a developing country.
authors.affiliation: Department of Laboratory Sciences, Graduate School of Health Sciences, Gunma University, Gunma, Japan. toyosida@health.gunma-u.ac.jp
authors.forename: Tomomi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Nishijima
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Hando
authors.forename: Soulideth
authors.initials: S
authors.lastname: Vilayvong
authors.forename: Petsamone
authors.initials: P
authors.lastname: Arounlangsy
authors.forename: Toshio
authors.initials: T
authors.lastname: Fukuda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000821:virology; D011247:Pregnancy; D011379:Prognosis; D013048:Specimen Handling; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult